Monday, November 29, 2004

Schizophrenia Treatment Should Focus On Recovery, Not Just Symptoms
Psychiatric News story - "Psychiatry has overemphasized pharmacotherapy of symptoms and underutilized proven psychosocial treatments, while paying little attention to the substantial medical complications confronting patients with schizophrenia, says one expert. Functional outcome, not merely symptom relief, should be the clinical focus in the treatment of schizophrenia, said Stephen Marder, M.D., in an address titled 'Recovery in Schizophrenia' at last month's Institute on Psychiatric Services in Atlanta. Marder called for a new focus by psychiatrists on the physical health of patients with schizophrenia and incorporation of the broad range of proven psychosocial treatments. He also called for a new research agenda aimed at developing drugs to treat cognitive deficits—the feature of schizophrenia most strongly associated with functional outcome..."  
  

Technical Report on Psychiatric Polypharmacy
A report (in Adobe Acrobat format) from the Medical Directors Council of the National Association of State Mental Health Program Directors, brought to our attention by Open Minds - "The purpose of these reports is to provide information and assistance to state mental health directors on emerging clinical and service system issues. The technical report topics are identified by the NASMHPD Medical Directors Council in conjunction with NASMHPD leadership. Reports in the series are developed by members of NASMHPD divisions, NASMHPD affiliates, and outside experts."  
  

Prospective Payment System for Inpatient Psychiatric Facilities - Final Rule
Centers for Medicaid and Medicare Services document,in Adobe Acrobat format, brought to our attention by Open Minds - " This final rule establishes a prospective payment system for Medicare payment of inpatient hospital services furnished in psychiatric hospitals and psychiatric units of acute care hospitals and critical access hospitals. It implements section 124 of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA). The prospective payment system described in this final rule will replace the reasonable cost-based payment system under which psychiatric hospitals and psychiatric units are paid under Medicare."  
  

Editorials, Opinion Pieces Address FDA Regulation Practices
A nice roundup in the Kaiser Daily Health Policy Report of more than a dozen editorials and opinion columns on the FDA's prescription drug monitoring system, with excerpts and links.  
  

Research suggests scan may detect bipolar disorder
Duluth News Tribune story reprinted at PsycPORT - "Bipolar disorder is a serious mental illness affecting about 2.3 million Americans, yet it can be difficult for doctors to diagnose. That may soon change, thanks to groundbreaking research at the Mayo Clinic in Rochester, Minn. Using a high-powered magnetic resonance scanner, researchers have found that patients with bipolar disorder produce significantly different brain scans than patients without the disorder. ... Researchers hope the specialized scanning can help identify 'metabolic markers of the disease'."  
  

Contracts Keep Drug Research Out of Reach
Feautre business story in the New York Times - "Last December, medical school researchers went to a professional meeting in Puerto Rico with a sense of urgency. Federal drug regulators were reviewing unpublished data from their studies on the use of antidepressants in children and adolescents to see if the drugs increased suicide risks. The group included many of the researchers whose published positive findings had helped persuade doctors to prescribe antidepressants like Paxil, Zoloft and Prozac to young patients. Now, faced with growing safety questions, the researchers had been trying for months to gather all the test data about those and similar drugs to see if they had missed a pattern not apparent in any single trial. But they could get only pieces of that information..." [Viewing New York Times resources requires registration, which is free].  
  

Police experiment with getting mentally ill help instead of handcuffs (Virginia)
Hampton Roads Pilot story - "The growing number of mentally ill people locked up in Hampton Roads jails is prompting searches for innovative solutions, from special courts to police programs. One approach, in Memphis, Tenn., has drawn interest from Virginia and is spreading to departments across the country. It emphasizes bringing mentally ill people into treatment – not jail. Members of the Memphis police crisis intervention team get 40 hours of training on mental health and conflict resolution, then regularly handle calls involving disturbed people. They work closely with a hospital that accepts people for psychiatric assessments around the clock. By contrast, mental health training for Hampton Roads officers typically consists of several hours in a police academy, with occasional refresher courses. No 24-hour psychiatric drop-off facility exists. Officers who think somebody should be detained must enlist a mental health professional and a magistrate – a process that can take hours. They may have to transport the person to a distant mental hospital. It is quicker to make an arrest..." See also two related stories at the same source - Local jails become holding facilities for mentally ill people and Jailing the mentally ill: a study in neglect.  
  

Mental health court proposed (South Carolina)
Carolina Morning News story - "Advocates for the mentally ill are trying to get a mental health court established in Beaufort County. But before they can help offenders who they say need treatment instead of jail, the group must also overcome challenges. Members of the Beaufort County chapter of the National Alliance for the Mentally Ill have been meeting with Probate Judge Francis Simon, other court officials and representatives of the Coastal Empire Community Mental Health Center. The group's goal is to set up a court similar to Beaufort County's Drug Court which would offer some non-violent offenders a chance to avoid jail if they get help and follow court guidelines, said local NAMI President Guyla Daley..."  
  

Mental health budgets may receive increase in state funding (Vermont)
Times-Argus story - "Gov. James Douglas is considering a plan that would boost spending on mental health agencies by 7.5 percent in each of the next three years. The plan is intended to avert the strife over funding that last winter brought busloads of clients and workers to a rally on the icy Statehouse steps. The protesters claimed the administration had proposed insufficient state funding for the regional agencies serving more than 30,000 needy and vulnerable Vermonters."  
  

Plans underway to improve state mental-health programming (California)
Story in the California Aggie - "With the passing of Proposition 63 on Nov. 2, state residents will begin to see a positively transformed mental health system over the coming months. The initiative, funded through a 1 percent tax on state residents' income that exceeds $1 million, will bring hundreds of millions of dollars into the system earmarked for improving the care of mentally ill children, adults and seniors. State and county workers intend to fully utilize the opportunities that this money will provide, while looking at long-term goals for California's mental health consumers."  
  

Enterprise aid for mental health sufferers (UK)
Story at Shout99 on a Phoenix Fund initiative - "Thirteen new projects to encourage enterprise among people with mental health conditions will be set up with £1.25 million of DTI funding, Minister for Small Business and Enterprise Nigel Griffiths announced. The 13 projects, based throughout England, will initially help more than 1,000 people with mental health conditions become self-employed, start a small business or social enterprise through mentoring, training, advice and hands-on support. Some will also help those already in business where illness is putting it at risk. They will be funded by the Phoenix Fund, the £177 million DTI programme set up to help tackle social exclusion by encouraging entrepreneurship."  
  

Mental Illness Sends Many to Foster Care (Virginia)
Washington Post story - "Almost one of every four children in Virginia's foster care system is there because parents want the child to have mental health treatment, a report commissioned by the General Assembly states. The study -- the result of a months-long examination of the state's foster care and mental health services -- chronicles the difficult decisions that thousands of Virginia parents have made to relinquish custody of their children to the foster care system so they can get mental health services that are otherwise unavailable or unaffordable." [Viewing Washington Post stories requires registration, which is free.]